血浆GFAP、FN及LMP2水平与急性脑梗死介入术后出血性转化及预后的关系  

Correlation Between Plasma Levels of GFAP, FN, and LMP2 and Postoperative Hemorrhagic Transformation and Prognosis in Acute Cerebral Infarction After Interventional Surgery

作　　者：徐忠海[1] 代允义[1] 马瑜[1] 代全德[1] XU Zhonghai;DAI Yunyi;MA Yu;DAI Quande(Department of Neurology,the First People’s Hospital of Shangqiu,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院神经内科,河南商丘476100

出　　处：《河南医学研究》2023年第13期2406-2409,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划项目(LHGJ20191487)。

摘　　要：目的探究血浆神经胶质纤维酸性蛋白(GFAP)、纤维连接蛋白(FN)及低分子量蛋白酶2型(LMP2)水平与急性脑梗死介入术后出血性转化(HT)及预后的关系。方法回顾性分析2019年5月至2022年5月商丘市第一人民医院收治的介入术治疗的80例急性脑梗死患者的临床资料。根据患者是否发生HT分为HT组(32例)和非HT组(48例)。比较两组患者血浆GFAP、FN、LMP2水平,绘制受试者特征(ROC)曲线分析患者血浆GFAP、FN、LMP2对HT的预测效能。根据患者治疗效果分为治愈组(11例)、显效组(33例)、有效组(27例)和无效组(9例),比较不同预后患者血浆GFAP、FN、LMP2水平,使用Spearman法分析患者血浆GFAP、FN、LMP2水平与预后的相关性。结果HT组患者血浆GFAP、FN、LMP2水平高于非HT组(P<0.05)。ROC曲线结果显示,血浆GFAP、FN、LMP2均具备较高对急性心肌梗死患者HT的预测效能(AUC=0.810、0.733、0.972,P<0.05)。治愈组、显效组、有效组、无效组患者血浆GFAP、FN、LMP2水平依次上升(P<0.05)。Spearman结果显示,急性心肌梗死患者血浆GFAP、FN、LMP2水平均与患者预后呈负相关(r<0,P<0.05)。结论HHT患者血浆GFAP、FN、LMP2水平高于非HT患者,GFAP、FN、LMP2水平可预测急性脑梗死患者HT发生,且与患者预后呈负相关。Objective To explore the correlation between levels of plasma glial fibrillary acidic protein(GFAP),fibronectin(FN)and low molecular weight protease 2(LMP2)and hemorrhagic transformation(HT)and prognosis after interventional surgery for acute cerebral infarction.Methods The clinical data of 80 patients with acute cerebral infarction treated with interventional therapy at the First People’s Hospital of Shangqiu from May 2019 to May 2022 were retrospectively analyzed.According to whether the patient has developed HT,they were divided into HT group(32 cases)and non-HT group(48 cases).The plasma levels of GFAP,FN,and LMP2 between two groups of patients were compared.Receiver operator characteristic(ROC)curve was used to analyze the predictive efficiency of plasma GFAP,FN and LMP2 on HT.The patients with acute cerebral infarction were divided into cure group(11 cases),markedly effective group(33 cases),effective group(27 cases)and ineffective group(9 cases)according to the treatment effects.The differences in plasma GFAP,FN and LMP2 were compared among patients with different prognosis.Spearman method was adopted to analyze the correlation between plasma GFAP,FN and LMP2 levels and prognosis.Results The levels of plasma GFAP,FN and LMP2 in HT group were higher than those in non-HT group(P<0.05).ROC curves showed that the plasma GFAP,FN and LMP2 had predictive efficiency on HT in patients with acute myocardial infarction(AUC=0.810,0.733,0.972,P<0.05).The levels of plasma GFAP,FN and LMP2 in the cured group,markedly effective group,effective group and ineffective group were gradually increased(P<0.05).Spearman results showed that plasma GFAP,FN and LMP2 levels were negatively correlated with prognosis in patients with acute myocardial infarction(r<0,P<0.05).Conclusion The plasma levels of GFAP,FN,and LMP2 in HHT patients are higher than those in non HT patients.GFAP,FN,and LMP2 levels can predict the occurrence of HT in acute cerebral infarction patients and are negatively correlated with patient prognosis.

关 键 词：急性脑梗死 出血性转化 神经胶质纤维酸性蛋白 纤维连接蛋白 低分子量蛋白酶2型 

分 类 号：R743.3[医药卫生—神经病学与精神病学]